Basic Information
| Provider Information | |||||||||
| NPI: | 1497730584 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | SPECCHIERLA | ||||||||
| FirstName: | RICCARDO | ||||||||
| MiddleName: | E | ||||||||
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| Credential: | PT | ||||||||
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| Mailing Information | |||||||||
| Address1: | 5962 LA PLACE COURT | ||||||||
| Address2: | SUITE 170 | ||||||||
| City: | CARLSBAD | ||||||||
| State: | CA | ||||||||
| PostalCode: | 92008 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8009294776 | ||||||||
| FaxNumber: | 7609318370 | ||||||||
| Practice Location | |||||||||
| Address1: | 19000 HAWTHORNE BLVD | ||||||||
| Address2: | |||||||||
| City: | TORRANCE | ||||||||
| State: | CA | ||||||||
| PostalCode: | 905031517 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3107931800 | ||||||||
| FaxNumber: | 3107931801 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 12/12/2005 | ||||||||
| LastUpdateDate: | 07/08/2007 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | X | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 225100000X | PT 24134 | CA | Y | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Physical Therapist |
No ID Information.